In a previous Health Alert I argued that the real issue in health reform is not health care. It is collectivism. The natural follow-up question is: Why is anybody a collectivist? It’s easy to understand why people are individualists. We’re all the product of selfish genes. But where does collectivism come from? Why does it persist?

To answer that question, I first need to explain the problem that needs to be solved.

In a world of rational, self-interested robots, there would not be what we conventionally think of as a collectivist. There would never arise a Lenin or a Stalin or a Hitler or a Mao Tse Tung. There would not be millions of entities subscribing to their various ideologies. Nor would there be any Franklin Roosevelts or any welfare state liberals.

With God on Our Side

That does not mean there would be anarchy. Social scientists understand that certain decisions are necessarily social, or collective. For example, if we are going to communicate, we need a common language. If we are going to trade with each other, we need a common law. If we are going to incorporate politically to protect ourselves internally we need a common criminal law. In dealing with outsiders we need common foreign and defense policies.

But aside from communicable diseases and common threats, there is no rational reason why health care decisions need to be made collectively. Nor retirement decisions. Nor is there any reason why my choice of how to insure against unemployment, disability or premature death needs to be the same as your choice. And, to state the obvious, there is no rational reason why we need to have the same incomes.

Not only is uniformity in these areas unnecessary, the desire to impose it is irrational. It is the existence and persistence of this irrationality that needs to be explained.

Continuing with our thought experiment, let’s endow our rational robots with sentiment — so that they are not indifferent to the suffering or the needs of fellow robots. The existence of this sentiment creates three immediate problems.

First is the public good problem. If all other robots care about the suffering of I Robot, then all other robots benefit from the relief of that suffering, whether or not they contribute to the effort. Under these circumstances, economists have shown that private, individual decision-making will generate too little relief for I Robot.

The second problem is the free rider problem. If I Robot knows that other robots are not indifferent to his plight, he has an incentive to not save for his retirement, not insure for his health care (robot maintenance), etc., knowing that the other robots will take care of him. In other words, the very existence of sentiment creates perverse incentives to game the system.

To many liberals, problems one and two constitute a prima facie case for coercion, exercised by the state. But that’s because they ignore problem three. Anytime you coerce people you keep them from doing whatever they otherwise want to do. And this runs the risk of making them worse off. Further, Phil Porter and I have shown (most recently here) that there is no known public choice mechanism (certainly not majority voting) that will produce anything close to ideal outcomes. This means that we face the likelihood (especially in certain areas) that coercive government programs will make society worse off than if there had been no intervention at all.

Also, since our robots are both (a) rational and (b) care about the welfare of all other robots, they would never impose uniform behavior on people if better alternatives existed. Better alternatives to a one-size-fits-all welfare state do exist, as it turns out. The Biblical idea of a tithe to the poor is an alternative to TANF and food stamps. At the NCPA we have turned the idea of a compulsory tithe into a taxpayer choice proposal. Of the many policy ideas I have developed, it is the only one that I can claim is truly God-given.

Anyway, this gets back to the original question. Why are people irrationally collectivist — wishing to impose far more uniformity and outlaw far more individuality than can ever be justified?

The answer is war. War? Yes, war. Or at least the African plains version of it. One million years ago — drifting down to, say, 100,000 or so years ago (by which time I assume the basic genes were well in place) our ancestors were in continual battles with each other over resources.

The ones who thought like rational robots — calculating cost versus benefit before acting — were at a disadvantage when confronting those who were willing to irrationally risk life and limb out of loyalty to the group. So the former group passed on fewer genes than the latter.

For lack of a better word, I will call the source of the impulse to subordinate self-interest to group goals the “collectivist gene.” It probably has a lot in common with the God gene in that it has evolutionary survival value.

I believe we all have a bit of the collectivist gene in us (although obviously some more than others) and it’s not all bad. The same gene (or set of genes) that produces leftwing nuttiness also produces patriotism, and bravery and heroism in battle.

It also produces such voluntary achievements as the election of Scott Brown in Massachusetts. In general, a rational robot would not vote at all. The reason? The expected benefit from voting is the benefit of the preferred candidate’s win multiplied times the probability that the robot’s vote will determine the outcome of the election. (But for his vote, the election would have ended in a tie.) And since that probability is infinitesimally small, the expected benefit from voting is infinitesimally small. The cost of voting (especially when it’s cold, sleeting and snowing) is not small, however. Hence, purely rational robots would stay home. It is the “irrational” commitment to group goals that spurs humans not only to vote, but also to give money, put up signs, canvass, poll watch, etc.

I don’t buy into the “God gene” explination. Genetics may have something to do with the human tendency to believe in God. However, the natural order of things makes a far more compelling case for the existence of a God – consider the earth and the millions of plant and animal species that coexist and make life possible.

I think the world of “rational robots” begs a lot of questions, such as the primary question of all, would they be “conscious,” and if so, would they be “individual.” Perhaps the answer is yes to both questions. It might still be the resulting case, then, that those separate consciousness’ would become interlinked by instantaneous communication capabilities (after all, they are robots, right?), and their minds essentially merged into a collective organism of which they each make up, effectively, separate “neural nodes.” Ultimately, this collective would be making the decisions acted out by the separate units that make it up. The danger of interconnectedness will always be the potential, even likelihood, of some “meta consciousness” arising, taking control, and overriding what used to be individually determined actions. I would prefer to unplug from the net in such a society than be assimilated. But, as the saying goes, resistance is futile.

John- interesting piece. If you factor in the notion of primal natural law, as in how do sentient beings behave in their most natural state, survival of the individual is the foremost concern, whether coded in the DNA or somewhere even more primal. If your rational robot is placed in a strange and threatening environment and faced with multiple potentially threatening beings, there is a natural affinity for beings similar to oneself. (babies naturally track visually to human faces preferentially to other shapes). That provides the nucleus for shared societal cooperation, but only to a point. The real question, I think, is how far that natural affinity carries the individual into the group and the tension that then develops when the interests of the one conflict with the interests of the group. I will look forward to the book!

John:
This is a fascinating and timely discussion.
I agree with you that we all have a collectivist gene in us, some more than others.
That seems to be a point of contention, when comparing it with the self-interest gene, which people would tend to agree exists.
From a strict point of survival of the fittest, I think that tends to favor self interest.
while people may work together, each party does so in order to survive.
Survive in our society means to accumulate enough dollars to live, and, hopefully, have some left over to enjoy life.
You mentioned war as being an area in which the collectivist (or God) gene tends to dominate.
My persopnal feeling is that there is a war on finite resources, dollars, to pay for a relatively infinite demand of health care.
This infinite demand is fueled by the will to survive.
It is a clash of desire to live versus the demand to live.
With household median income at $55,000, and family group premiums averaging $13,000, this war will only grow more intense.
The desire of the government to pay for the necessity of health care that is priced as a luxury, via subsidies, will only delay the inevitable war that will ensue.
Debt, whether individual or collective, merely masks the underlying tensions which will rise to the surface.
It does nothing to improve the conditions which produce the tension.
Don Levit

Don – for purely “macro” level perspective on the scope of the problem, your comments that relate average group premiums to median income are close to the mark, but such premium figures leave out a lot of the total burden healthcare expenses are to the typical household, since it doesn’t reflect out of pocket costs, nor the “shared” cost of public expenditures. I develop what I call a medical expenditure burden index by simply taking total expenditures per capita data readily available (though includes a lot of different items), adjust them to a household level by using census data on average persons per household, and then do the comparison with the median household income (median is of course the preferred, though not perfect, statistical measure). The current best estimate result for 2008 figures I have is 38.38% of median household income, of which the “private” expenditure portion is 20.22%. The public portion has been steadily increasing and for 2010 will probably be about equal to the private percentage, both around 20% or higher. When compared with actual “cash” outlays for portion of premium and out of pocket and actual payroll deductions for a household, this burden measure is much higher, of course, because household income is only about 6 trillion of the total 14.2 trillion GDP for 2008, but it is kind of enlightening to view the cost this way! If we only had payroll to get a national health plan tax from, just how big would it really have to be, even counting an “employer” portion?

I want to share my feelings about health care since I’ve just returned from a five-day cruise in the Bahamas and had a chance to observe people from 54 different countries. 95%, I’d guess, were overweight. Conclusion: we eat too much. If we would set up the healthcare system in a way in which people are rewarded for staying slim and trim, we’d save millions, look better, and feel better. Overweight (or obesity) causes more health problems than any other single behavior. It’s caused by eating too many of the wrong foods, little to no exercise, etc., etc., etc.

If we all modified our behavior in this area, there would be less need for doctors, hospitals, nurses, and so on. If we continue in this mode, we will need more and more healthcare providers. And, of course, higher and higher premiums for our care.

John, you make this much too complex.
The collectivist panders to the atavistic warm sense of solidarity and altruistism of our genetic tribal instincts. The pandering sells the collectivists’ rationale of why state enforced altruism is “rational”. It is irrational, since state diktats disrupt the the traditional rules of human behavior–propety rights, contract, trade, competition, price information, etc. It is these rules on which we all depend for our very survival. Read FA Hayek, “The Fatal Conceit” chapter 1 for a full analysis of the collectivist mind-set. Bob

Thanks, John, great post. For some interesting reading on the balance between the “collectivist gene” and rational action, see Howard Margolis’s Selfishness, Altruism, and Rationality: A Theory of Social Choice (ISBN 978-0226505244).

HD:
Your calculations sound very interesting.
I am curious what figures make up the “public portion?”
Would they include cost shiftinmg from Medicare and Medicaid as well as payroll taxes to fund Social Security and Medicare?
Bob:
I am curious if you are for the proposed subsidies for health insurance premiums?
Once government subsidies are included, it seems to me that the program is no longer one of Hayek’s “choosing.”
The FASAB, which is the accounting advisor for the federal government, seems to agree with me.
Here is an excerpt from pages 27-28:
“Insurance and guarantees other than Social Insurance – Federal programs that provide protection to individuals or entities against specified risks. Many of these programs were established to assume risks that private sector entitries are unable or unwilling to assume (at least at prices that beneficiaries of the program can afford)or want to pay or to subsidize the provision of insurance to achieve social objectives. Includes such programs as PBGC, National Flood Insurance Fund, FDIC, and loan guarantees.”
Go to:http://www.fasab.gov/pdffiles/tabc_092006.pdf.
It seems to me that we are unable to achieve the social objective of portable, affordable coverage without the subsidies.
And, of course, I haven’t mentioned the health tax exclusion, which is by far the largest tax giveaway available, far surpassing the home interest deduction.
Don Levit

Great article! Why is is so hard for people to see that government are root of so much evil? Oh yeah, governments run the schools, license the broadcast media and government-loving professors control the universities. Hey maybe we might want to take Ayn Rand’s advice and start at the top…the universities.

A very timely post John. Thanks. It is timely because perhaps now we have finally forced the removal of the healthcare reform issue from hysterical anecdotal imperatives for radical change to discussion of the true ideology of the American citizen. It seems that once the citizens realize exactly what the administration’s version of “reform” means, they have an entirely different idea of what is appropriate.

Thus, a further step would be to explore the source of these now clear ideological chasms among otherwise similar folks. Of course, Mark Levin has addressed this in a somewhat less clinical but more political tact in his book “liberty and Tyranny”. But approaching it from the anthropological point of view would be very interesting.

Even more interesting is your piece on “taxpayer choice”. I have wondered for a long time why this approach has not attracted any serious political discussion among libertarians and conservatives (or logical thinking robots).

Don – I checked the source (it is just the National Health Expenditures Accounts at CMS) and government employee health insurance is counted as “private,” though all defense department and VA costs are included with Medicare, Medicaid, etc., in the “public” category. As pure accounts figures, they of course do not include any estimates of what “should” be shifted over from the private category to represent the hidden tax of cost shifting – a good observation, but probably not easy to estimate. It should also be pointed out that there is no “present value” accounting or amortization of the unfunded future liabilities for public employees of various levels, let alone Medicare. We are kind of stuck in a pay-as-you-go trap with these figures.

I see a thread through a lot of comments dealing with the concept of “affordability,” either directly or indirectly by making reference to “affordable” premiums, etc. In addition to a number of other terms critical to a discussion of the subject (such as what do we mean by “health care”, for example) I believe that coming to terms with the true cost of health care is one of the sticky bits to achieving potentially rational solutions, which is realizing that what we have deemed to be health care may not be “affordable” in any real sense. And yet, politicians of all stripes hawk a promised land of “affordable” health care. Even if it is perceived as being affordable to a given person through a subsidy for a premium, the question must still be asked if it is affordable for society as a whole? Clearly, affordability is in the eye of the beholder, and who will say which view is the correct one?

John, you raise some interesting moral and philosophical questions. I know from my personal circle of friends, those that support government largesse are also among the most secular of my friends. It has taken the election of Obama for me to recognize this gulf between myself and certain segments of my range of friends. Collectivism to them is the natural outreach of humanity and of course, we need a conduit to organize and disseminate money, support, ideas to those in need and that conduit is government because in their eyes, religion is too discriminatory and exclusive, business is too profit oriented and therefore, inhumane, private charity is not enough to reach the masses and individuals are just that–small and insignificant to tackle the problems of the world.

I have friends that lived in Ireland for 8 years and had a circle of friends from all around Europe. A friend of theirs from Sweden related how nobody stops to help stranded motorists because they figure the government will be there shortly. Socialism absolves individual responsibility and that’s the way the secularists like it. They prefer to “donate” to government and take refuge that their tax dollars are their “contribution to society”.

Provocative. Where in this theory does power and the gullibility factor come into play? Collectivists seem more gullible to others who want collectivism for the self purpose of power. As you stated, colectivist seem to buy into the collective benefit when the opposite is always the outcome. Irrational. I understand the argument that it may have come from some collective value of group hunting and group protections against death threats by manmoths, but no it seems to have morphed into a co-dependent characteristic of gullibility.

When we speak of the collective versus the individual, insurance is one area in which both are important.
Without enough individuals to spread the risk, the benefits would be too minor to attract interest.
In addition, the “insurer” must look out for the collective interests as well as the individual claimant’s interest.
However, if one had to choose which interest is paramount, I would choose the insurer’s interest, in effect, the collective’s interest.
The “insurer” would need to survive over the interests of the individual.
It would be distinguishing between situational ethics and sustainable ethics.
Situational ethics asks “What’s best for the collective in the long run?”
Situational ethics asks “What is best for me and my family in the short run?”
Don Levit

John, thanks for linking to the taxpayer choice proposal. (http://is.gd/83Ocp) I’ve suggested this idea as a way to make Medicaid compete fairly with private charities, but up to this point had not seen anyone else propose it.

While most people oppose getting rid of government-run charities all together, I think many would be open to this idea. Anyone who opposes it risks being labeled lazy and irresponsible: they don’t care enough to choose which charity to give to and judge which charities do a good job. They want government to choose for them. How can someone with this preference claim to care about the people government charities are supposed to help?

Individualism can be best realized in a cooperation with others is one belief… e.g. the Swedish Model.
Individualiam can be best realized without help of others or the state or community… e.g. major ethos of Texas.

Takes a village to raise a child .. who disagrees with this notion? Extreme individualist?

Family is a collective ..who disagrees with this?

A school is a collective response to an education of children ..who disagrees with this?

This idea certainly seems, at least to a lay person, to have considerable face validity.

Would you have to take it to the point of researching for and ultimately writing the book to know how scientifically validate-able the idea is? Would you need to co-author with a biologist and an anthropologist in order to create scientific credence?

I couldn’t tell from reading the article how literally versus metaphorically you meant the notion of per se “collectivists genes”.

John, I am writing to my politicians that why pay taxes and have government bureaucracy determine what you need. That will be much more expensive than if you pay insurance companies or pay doctors and hospitals directly, even though they will raise their prices. You can always shop. It may force Americans to take care of themselves better. Once you pay taxes, you know for sure you won’t get your money’s worth. I have sent 5 letters today.

I appreciate your writings as you have thought out every government scheme for years. I think part of the problem is actuarial assumptions and marked changes in life expectancy. I know people will have to work longer, if there are jobs, save more and count on themselves and their relationships to medical providers.

I still believe a personified government would like its creditor/taxpayer to drop dead to avoid paying its unanticipated over promises.

I partially agree with this, but think that the real explanation is inherited aggression. The early humans who survived were the ones who were aggressive. Aggressiveness leads to efforts to subdue and dominate. Dominating species that have special abilities, like fellow humans, offers significant advantages, because they can do so much more for the masters (as in slavery) that inferior non-human species. What good derives from humans dominating chimpanzees, for example?

Dominating fellow humanoids who refuse to be dominated leads to war, and most likely led to the extinction of certain early species of humans. This innate characteristic of human nature put enormous selective pressure on intelligent. Those who were the smartest were most likely to be the most successful in war.

When war is not feasible, as in politics in a civilized democratic country, dominance takes the different form of government edict. Power flows to those who make laws that everybody else has to obey. Thus, we reach the perhaps unexpected conclusion that the most aggressive people today are political, big-government liberals. As they acquire the levers of political power, they get to tell everybody else what they must do. Nobody but me, I suppose, would arrive at such a conclusion (and I hadn’t either, until now).

Anyway, that is my take. Reading E.O. Wilson’s Sociobiology book might help, but I don’t think it has much on humans in it.

One of the fans sent me some questions about my recent post, in which I argued that innate aggression lies at the heart of this debate. Here are the questions and my response:

Q1. I’m wondering: If laws are the new form of social aggression, does that make liberterians the least aggressive of the species?

A1. Laws are not a NEW form of social aggression. Whenever they are imposed, by a King, a dictator, or even a parliament, it is commonly for the purpose of constraining human behavior to suit the wishes of the ruling elite. Democracy is the only known method of minimizing abuse, and we have seen that it does not always achieve this end.

Though I personally don’t subscribe to Libertarian philosophy, I would think they are the least aggressive of the political class. They have the least tendency to tell people what they can and cannot do.

Q2. If so, does that imply something about liberterian intelligence?

A2.I don’t think intelligence is the issue. There are smart and dumb liberals, conservatives, and libertarians. Now it is true that aggressive people feel superior to those they wish to dominate. Thus, liberals are prone to believe that conservatives and libertarians are not as smart as they are (Al Gore is considered a genius, while Sarah Palin is considered a cretin)(actually, in my view, neither is very bright).

Q3. Or can we say that aggression in a developed society is a misplaced instinct leading to a waste of our resources?

A3.In the political sphere, the purpose of aggressive instinct is not to utilize resources appropriately. It is to dominate.

Q4. And if liberals are the most aggressive of all, then why do they always talk about protecting rights and making the playing field level?

A4. Because it sells. In a democracy, it is a way to garner a reliable piece of the voting marketplace. If you can arrange for half of the public to get more from the government (as with entitlements) than they are required to contribute (as with taxes) then you have locked in permanent control of the political process. By the way, our country is just about at this breakpoint. The new medical reform bill that Obama wants will push us to that point.